Sending patients to ER

[jmathe23]

Hi all,

Im a new grad NP. I work in heme/onc at a large academic institution. We often send our patients to ER. I’m wondering when you send your patients to the ER, do you always call report to the ER in advance?

[verene, MSN]

I usually do just because ED docs locally are notorious for writing off psych patients. I try to make it super clear that I am sending from another HOSPITAL (with primary care level medical on site... we just aren't an emergency level facility) and my rational for WHY the patient needs a higher level of medical care than we can provide AND how to manage the patient's psychiatric needs while in ED (which a lot of the ED docs appreciate) and my patients are COURT COMMITTED and MUST be sent back to me when medically stable. (So please, please, please, do not plop them on the side walk and try to send them back via taxi...)

[KatieMI, BSN, MSN, RN]

I always did that. ER people appreciated it because otherwise they very likely would be stuck with clinic/SNF "report" on the level "oh, I do not know anything about him but I was told that they just wanted to check him up for not waking up or something, it all should be on computer, bye", two EMR systems without knowledge of each other and patient A, Ox2 at the best who knows he was sent here from there because "my doctor said I had to go".

Couple of times it saved the day.

[egg122 NP, MSN, APRN]

Yes, absolutely. I will also fax labs or ECGs over to them if I have them.

[Guest1144461]

Always. Send relevant documents too. It's sooooo annoying when we get a transfer some outlying hospital with a packet full of ED nursing documentation and no d/c summary, imaging or even a H&P. Suuuuper helpful, not.

[MikeFNPC, MSN]

We're all on the same team. Calling the other team members to give a heads-up, in my experience, has always been met with appreciation.

It's also a good way to avoid getting thrown under the bus by the ER, which can easily show up in their HPI.

[Shoe, APRN, NP]

I work primarily urgent care now and always give some report to the ER when I send a patient there. I have worked ER for many years, and especially with heme/onc patients, I would appreciate receiving a call from the cancer clinic to let us know they were coming, and what direction they wanted us to take with their care, as these can be more complicated patients for us.